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2012 W 25th St #720 Cleveland OH 44113-4135 | |
| (216) 687-0062 | |
| (216) 687-9529 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2012 W 25th St, Cleveland, Ohio |
| Authorized Official Name and Position | Sara Nazco (DDS) |
| Authorized Official Contact | 2166870062 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2012 W 25th St Cleveland OH 44113-4131 Ph: (216) 687-0062 | 2012 W 25th St #720 Cleveland OH 44113-4135 Ph: (216) 687-0062 |
| NPI Number | 1255382800 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 10/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255382800 | NPI | - | NPPES |
| 0918476 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3019317 (Ohio) | Primary |
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